Abstract:
While various treatment options for primary snoring are available, evidence-based recommendations to determine the optimal intervention remain unestablished. To inform future directions of research to guide clinical decision-making, this scoping review was conducted to map the existing evidence on interventions for primary snoring, the outcomes and instruments used to assess their clinical effects in adults. The feasibility of conducting further systematic reviews and comparing outcomes across these therapies using network meta-analysis was also assessed. Of the 1673 records identified, 38 interventional studies met the inclusion criteria with three-fifths of them being before-after studies. The most common reason for study exclusion was results being reported for patients with primary snoring and obstructive sleep apnoea (OSA) combined. Interventions were surgical (73 %), behavioural and the use of devices/medications. Twenty-six common outcomes were identified and categorised into six domains. Fifty-nine instruments were used to assess the outcomes and based mainly on non-validated questionnaires. Our findings indicated (1) the need for randomised controlled trials with strict discrimination between patients with primary snoring and OSA, (2) further network meta-analyses using some outcomes is feasible, and (3) a core outcome set to inform standardised reporting for future research should be developed.
摘要:
虽然各种治疗原发性打鼾的选择是可用的,确定最佳干预措施的循证建议仍未建立。告知未来的研究方向,以指导临床决策,进行这项范围审查是为了绘制有关原发性打鼾干预措施的现有证据,结果和用于评估其在成人中的临床效果的工具。还评估了使用网络荟萃分析进行进一步系统评价和比较这些疗法的结果的可行性。在确认的1673条记录中,38项介入研究符合纳入标准,其中五分之三为前后研究。排除研究的最常见原因是针对原发性打鼾和阻塞性睡眠呼吸暂停(OSA)合并的患者报告的结果。干预是手术(73%),行为和设备/药物的使用。确定了26种常见结果,并将其分类为6个领域。使用了59种工具来评估结果,主要基于未经验证的问卷。我们的研究结果表明(1)需要严格区分原发性打鼾和OSA患者的随机对照试验,(2)使用一些结果进行进一步的网络荟萃分析是可行的,和(3)一个核心结果集,为未来的研究提供标准化报告。